What causes severe diarrhea with extereme weakness?
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83 y/o white remarkably healthy we'll nourished alert Active woman. Walks 5-6 miles a week and can still ride her two wheel bike on flat streets in warm weather. History of cataract 09 & thyroid 1964 surgery. 1986 hiatus hernia, 2006 osteoarthritis, 2010 diverticulosis NOT on any script meds. Presently taking: multivitamin, calcium, fish oil, glucosamine, omeprazole, alleve, ASA 81 mg 2/8/14 diarrhea x 7 hrs, no fever or vomiting,self treated with Imodium, bananas and Gatorade After diarrhea subsided c/o generalized upper and lower extremity weakness 2/9/14. 22 hours later after diarrhea Two man assist needed for ambulation To ER Quickly evaluated for stroke Neg CBC WNL. Electrolytes WNL, except lactate chest X-ray clear, ua neg 1500 ml normal saline administered Discharged needing two man assist. Remained weak, good fluid and food intake, output sufficient, no BM, A febrile 2/10/14 Today very weak, used rolling walker for first time, only able to weakly shuffle, so weak slid to floor x 2 While in bathroom felt, hit head on wall, no LOC, no bruising, no headache Falls occurred w/I 4 hours Returned to ER. CAT neg, 2nd chest XRay neg, CBC WNL 24 hour urine culture positive Admitted being treated with a ceph antibiotic Doctors baffled?????? Would you kindly offer some rule - outs. Reyes??? In major Long Island Medical Center
Posted Mon, 3 Mar 2014 in Brain and Spine
Answered by Dr. Sudhir Kumar 1 hour later
Brief Answer: Could be Guillain Barre syndrome Detailed Answer: Hi, Thank you for posting your query. I have noted the details. In this scenario, we need to exclude a diagnosis of Guillain-Barre syndrome (GBS). In GBS, there could be generalized weakness of arms and legs, which can rapidly progress, to involve speaking and swallowing muscles. The diagnosis of GBS can be confirmed or excluded by doing nerve conduction studies. Other cause of muscle weakness could be muscle inflammation. Serum CPK (Blood test) would be elevated in this condition. In addition, a deficiency of potassium or calcium should also be excluded. I hope my reply has helped you. I would be pleased to answer, if you have any follow up queries or if you require any further information. Best wishes, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist Apollo Hospitals, Hyderabad, For DIRECT QUERY to me: http://bit.ly/Dr-Sudhir-kumar My blog: http://bestneurodoctor.blogspot.com/